In June 2007, I was delighted to receive the British Association for Counselling and Psychotherapy’s highest honour for “distinctive service in the field of counselling and psychotherapy” when I became a Fellow. It was something I’ve always been very proud of, not least because the Organisation tended to only confer Fellowships upon people who have chaired their internal committees and that held no interest for me. One of the other people honoured on the same night was my friend and co-author Professor Lynne Gabriel who the following year went on to Chair BACP’s Board of Governors.

However, as the years have gone by, I’ve become an outspoken critic of BACP. If you just flick through previous blog posts, you’ll see I probably blog about them more than any other topic!

This time last year, I decided to save my £200 and not renew my membership. I’d been a member for 30 years. I’d threatened to do it the year before when BACP was dragging its stilettoes about extending protections to trans and gender-expansive people about expanding the Memorandum of Understanding (MoU) on Conversion Therapy. My actual resignation brought a request from the Chief Executive and current Chair of Governors to meet with me to hear my grievances. I was incredibly surprised by this consulted widely to ensure I could use the opportunity to explain the widespread dissatisfaction with the organisation. At our meeting, they received a 13-page document of comments and concerns from members of our Pink Therapy Facebook group and six critical points for my motivations for leaving.

Apparently, I was permitted to remain a Fellow even if I wasn’t a member, and for sentimental reasons, I decided to continue to do so. But with recent events, I’ve changed my mind. I am renouncing my Fellowship as I feel incredibly angered by their incompetence and duplicity. I realise this is an empty gesture as probably no-one gives a fuck, not least anyone at BACP, but I feel contaminated by associating my name and reputation with theirs. I’ve had enough of them!

The debacle in the latest issue of Therapy Today whereby the editor (despite having been informed of the transphobic nature of an organisation called Transgender Trend (TT) decided to publish two letters effectively advocating for conversion therapy for trans teens and in clear breach of BACP’s undertaking to support the MoU. Incidentally, neither of these two letter writers was a member of BACP. Within 24 hours around 600 people (many of whom are therapists working with trans clients) signed a letter of concern to BACP. I was furious to see the petty spite and gross immaturity of TT’s supporters when they heard of the open letter and used it as an opportunity to leave spiteful and transphobic comments.

The editor and Chair of BACP have both made statements of apology for the Transgender Trend letter, but have remained silent on the one from Bob Withers who is a UKCP Registered Psychotherapist and member of the British Psychoanalytic Council – both organisations are signatories to the MoU, and I await his censure by those organisations.

It isn’t the first time the editor has been criticised for her lack of understanding of the field of counselling, and there have been numerous calls for her resignation. However, her appointment points to incompetence at the heart of the largest counselling body in the UK. BACP like to think of Therapy Today as a professional journal much of the content is behind a paywall, but the quality is severely lacking due to a lack of experience. Both the COSRT and BPS journals are edited by highly experienced professional therapists. However, many of my colleagues report dropping it directly into the recycling bin which is probably where it belongs!

I am pretty upset about tearing up my certificate as I used to be proud to be associated with BACP, but I’m saddened to say, those days are long gone. I have found a much more welcome home with the National Counselling Society, who two years ago also made me a Fellow and last month appointed me Ambassador for Gender, Sexual and Relationship Diversity.

I was delighted to learn that the BACP Board of Governors decided to sign up to an inclusive Memorandum of Understanding to extend protections to trans people and asexuals.This still hasn’t been published on their website but will be soon.I am grateful that to everyone who played a part in lobbying the Board with their views, research and concerns. I think this has been immensely helpful in helping the Board decide that these protections are needed.

All the signatories to the MoU need to follow their due process and consider the implications for signing up and extending the protections.BACP were doing just that.It had been reported elsewhere that they had refused to sign, and this was a distortion of what I had been stating, that the Board were to meet in Early March and the indication I’d had was that they might decide not to sign based on “a lack of evidence & research.”This research was then supplied and the Board of Governors were able to make an informed decision.

I’ve been mulling over whether to still resign over my broader dissatisfactions with BACP. However, I think to resign at this point might look like this queen has had a hissy fit.

BACP ought to be well aware of the significantly higher rates of mental health problems within the LGB and T community based on research they commissioned in 2007.However, I am saddened that they’ve not used their considerable resources to ensure that counsellors are adequately trained to support LGBT people.Their signing up to the Memorandum of Understanding makes this an obligation and I am hopeful they will be auditing their accredited courses more closely on their attention to issues to GSRD issues.

I had hoped that having been made a Fellow in 2007 for my “distinctive service to the field”that this might signal an opportunity to collaborate in improving the mental health of Gender, Sexual and Relationship Diversities (GSRD). BACP also published my article Not in Front of the Students about the absence of training in their journal in the same year.But nothing has changed and I’ve felt quite dispirited. Instead, BACP have promoted workshops on treating sexual addiction which is a highly contested and controversial issue which many of us in the field of clinical sexology would dispute See Marty Klein who has blogged extensively on this or the excellent book by David Ley Ley, 2013, Flanagan 2013 and my post Davies, 2013) Sexual Addiction or Hypersexual Disorder failed to be included in the latest Diagnostic and Statistical Manual (the bible for mental health disorders compiled by the American Psychiatric Association) on the grounds of lack of robust evidence for diagnosis and effective treatment.

One of the positives that has come from my having taken stance is that MANY therapists and members of the GSRD communities have been having a conversation about therapy and it’s need to catch up with the rapid evolving field and address the mental health needs of our communities. [Over 80 concerned therapists and sexologists signed an open letter to the Board.]

It always surprises non-counsellors when I tell them that in what can be between a three to seven year training to become a therapist there is virtually no training in basic human sexuality and relationships let alone in working with people whose sexuality is different to the mainstream. Unless one trains to be a sex therapist, one is unlikely to be able to engage in explicitly sexual conversations.

Perhaps all of this activity over the past few weeks can pave the way for a closer dialogue between all of us who are concerned to see better mental health for our communities. We’ll see!

I wanted to say how incredibly moved I am by the level of support I’ve received since announcing my resignation from BACP yesterday.I had no idea that my social media influence was quite so effective and I’ve been overwhelmed by the positive comments of gratitude for taking a principled stand and raising awareness of their failure to address the mental health needs of our community.

I have also been deeply saddened by seeing the high level of disaffection with BACP – the largest counselling and psychotherapy body in the UK.

“..Removing yourself from such an organisation and doing so publicly gives a voice to all those lgbtq people who have suffered from BACP’s heel dragging and it also empowers the new Society by having you give authority and credence to its stand on issues of sexuality, orientation, and expression.”

I’ve sat by for almost 35long years hoping BACP would do the right thing and address the issues of improving the quality of mental health provision for LGBT people.

It’s not as if there are no gay people working in the highest echelons of BACP. But it’s largely cis white gay male privilege reinforcing the status quo from within. I recall in my early days of attending BACP annual conferences (when they had such things) that I’d be largely avoided by ‘discretely’ gay/bi senior officials – fear of guilt by association.But it gave me some sense that BACP might be alright and looking out for us.

Sadly this is not the case.They’ve done very little over these three decades to raise the standards of counsellor training to help therapists feel more comfortable discussing sex and relationship issues let alone anything less mainstream like Gender, Sexual and Relationship Diversities (GSRD).I’ve written about this before: Not in Front of the Students in 2007. Nothing’s changed as Meg-John Barker and I reported last year in an article on the UKCP Journal The Psychotherapist

Meanwhile I’ve ploughed my own furrow and made way for a new generation of GSRD therapists and had the privilege of training and working alongside many of them. Developing courses to fill the gap left by the heteronormative mainstream has failed to address.

As Audre Lorde said:
“For the master’s tools will never dismantle the master’s house. They may allow us to temporarily beat him at his own game, but they will never enable us to bring about genuine change. Racism and homophobia are real conditions of all our lives in this place and time. I urge each one of us here to reach down into that deep place of knowledge inside herself and touch that terror and loathing of any difference that lives here. See whose face it wears. Then the personal as the political can begin to illuminate all our choices.”

It’s fascinating that BACP has never sought to create a division around gender and sexual diversity issues.The old PSRF (Personal, Sexual, Relationship and Family) division got rebranded ‘Private Practice’ and there was, for a few years a RACE division but that limped along poorly supported and so as Lorde predicted, the queers and those of colour created their own spaces for support, training and development.The Black and Asian Therapists Network (BAATN) is a thriving active body which meets regularly in London (co-incidentally in the same building as we run our training workshops).

Over the years, largely because of the lack of attention to diversity, I have programmed many large conferences addressing gender, sexuality and relationship diversity issues.Personally taking the risk of financial loss if they’re not well enough attended (and one of these cost me £3k of my savings).I am enormously committed to improving the quality of therapy available and the training of therapists has been a major focus of my career. Pink Therapy receives no grants or external funding.It’s entirely funded from training course fees and directory membership fees. We’ve also followed BAATN’s lead and developed a mentoring scheme because of the endemic homophobia, biphobia and transphobia many counsellors feel in their training courses.

So it feels a kick in the teeth when I hear from people whom I’ve always respected that they feel there is a lack of evidence that Conversion Therapy is being practiced on trans and gender variant people and on asexuals.They may not know of it happening, they may not have seen the research, but that DOES NOT mean there is no evidence! (yesterday I cited several studies). Those of us closely connected to the Trans and Asexual communities are hearing all the time about how crappy therapists have been, how inappropriately they’ve treated them. It’s unfortunate that BACP are so out of touch and uninterested in learning from our communities.

Conversion therapy in the UK is also on a pretty small scale and I’m not sure there has been much ‘evidence base’ for that apart from Bartlett et al who found appalling levels of ignorance amongst mainstream counsellors responding to requests for reduction in their same-sex attractions.But these therapists wouldn’t have said they were doing “conversion therapy” which is a term largely used by fundamentalist Christians or the Orthodox Jewish organisation Jonah.Conversion therapy IS big business in the USA but here in the UK it’s more that well meaning, under-trained therapists agree to try to help a distressed client manage their same sex attractions by encouraging them towards heterosexuality.This is highly analogous to CAMS and other therapists working with children and families who present with gender non-conforming behaviour brought by their concerned parents worried that their child might be gay or trans and being advised to discourage cross gender play.

I am looking forward to taking up membership of what seems a much more supportive and progressive, albeit smaller counselling body – the National Counselling Society who have a policy of accepting members who are already accredited elsewhere in at the same level as they were.So in addition to my existing membership and Senior Accreditation with the National Council of Psychotherapists (who few people seem to know about), I will become enjoy Senior Accreditation and continue to be on the PSA Register.It was tempting to consider joining one of the more renegade groups of therapists like the Independent Practitioners Network, whom I have enormous respect for, but actually I want to be able to try to influence the profession by being a member of a larger body where we can hopefully raise awareness of equality and difference.

I was very troubled to hear though, how BACP seem to be holding a monopoly on who employers recognise as being THE accrediting/registering body for the profession.One person commented on my post that he didn’t feel he could leave BACP as the NHS (in Wales) wouldn’t recognise membership of any other professional counselling/therapy body.

Another respondent said: I’m a referral counsellor for a therapy centre based on my BACP accreditation, it would mean losing my livelihood unless I could persuade the therapy centre to accept the National Counselling organisation that Dominic mentioned…certainly needs to be thought through before I make any moves as I’m not in a financial position just to leave here not to mention all of the clients I currently see here, many of whom are trans or LGB…

I feel incredibly let down by my professional body – an organisation I have been a member of for almost 35 years and where I am a Senior Accredited Counsellor/Psychotherapist and a Fellow.They have indicated that they are likely NOT to be signing up for a revised Memorandum of Understanding on Conversion Therapy which would be extended to include trans and asexuality.

I am so frustrated by their constant inaction and lack of understanding the issues that I am resigning.Here are some of the reasons why:
As LGB and T people are over represented in the therapy-consuming population, due to demonstrably higher levels of mental distress and self harm there is an obvious and urgent need for counsellors to be able to provide skilled therapeutic support.

This is a rapidly changing field in terms of our knowledge about gender and sexual minority groups, language and concepts are continuously shifting especially with regard to trans issues.

There has been fairly recent legislation affecting LGB and T people’s rights, which therapists are likely to be unaware of.BACP has an obligation to ensure that therapists are to be kept up to date on all this.

Consistently research has demonstrated that LGB and T people have felt poorly served by therapists.As BACP is the largest counselling professional body it’s likely to be the case that there will be a great many members who have not responded appropriately.

In case you’re interested: Cordelia Galgut researched lesbians experiences of therapy, Iggi Moon conducted research into therapists attitudes to bisexuality, Tina Livingstone did a similar study but exploring therapists attitudes to trans people.Karen Pollock researched how comfortable suicidal trans people felt about seeking counselling. Bartlett et al did a large study on the response of mental health professionals to clients seeking help to change sexual orientation ALL found appalling attitudes by counselling professionals to gender, sexual and relationship diverse groups.

The MoU v1 items 18 and 19 make it an obligation that members of the signatory bodies i.e. BACP counsellors should be adequately trained to know how to best respond when someone presents with confusion over their sexual orientation or is seeking a reduction in their same sex attraction or a ‘cure’.

“18 Those with a responsibility for training will work to ensure that trainings prepare therapists to sufficient levels of cultural competence so they can work effectively with LGB clients;

19 Training organisations will refer to the British Psychological Society guidelines on working with gender and sexual minority clients when reviewing their curriculum on equality and diversity issues;”

BACP took two years to resolve a case where someone (an undercover journalist investigating gay cure therapy in Britain) sought the help of a BACP Senior Accredited therapist (Lesley Pilkington) and was offered ‘gay cure’ therapy.One of the major obstructions in the complaints process was to be able to find an unbiased/neutral complaints panel. I think BACP were also very scared that Pilkington was being defended by the Christian Legal Centre. BACP subsequently wrote to all members making it clear members were not to engage in reparative therapy, but have done very little to improve the confidence of therapists to know how best to respond to such requests from clients since then.

“14: For organisations with practitioner members, each will review their statements of ethical practice, and consider the need for the publication of a specific ethical statement concerning conversion therapy”

Today, I was informed in a “courtesy call, as a Fellow of BACP and someone very involved in these issues” that BACP don’t want to create an ever growing “list of orientations and conditions” [my emphasis], when the Ethical Framework already has principles which make unprofessional and incompetent practice unethical.

They want to just rely upon their Ethical Framework (and there is a new one out in July) which is based on ethical principles, currently they are: autonomy, trustworthiness, beneficence, non-maleficence, justice and self respect.http://www.bacp.co.uk/ethical_framework/ethics.php to ensure members act appropriately and ethically.

However, how are therapists supposed to be able to deliver competent and ethical therapy without specific training about gender, sexual and relationship diverse clients?For example, without knowledge of the specific mental health needs and socio-cultural contexts in which minority stress and micro aggressions contribute to much higher rates of depression, suicide and self harm, (with bisexuals and gender variant people having significantly poorer mental health than lesbians and gay men).Research into self harm amongst trans people shows that over 40% of trans people have attempted to take their lives or self harmed, about how relationship dynamics are often different amongst LGB people; about working with gender variant young people.There has been a 400% increase in referrals to the child and adolescent Gender Identity Development Unit at the Tavi and many therapists in community settings are working with young people and their families around gender identity issues.We are increasingly hearing stories from trans people about poor understanding of their issues.Including accounts from gender non-conforming young people being encouraged to follow to gender roles appropriate to the sex they were assigned at birth (i.e. boy’s shouldn’t play with dolls or dress in female clothing etc).

I think BACP are failing to support their members in learning how best to respond to gender, sexual and relationship diverse clients.The occasional article in the Therapy Today does not count as adequate attention to the training and development needs of it’s members.

It’s my view that BACP has become a large bureaucracy which has failed to use it’s power and resources to address the failures of the counselling profession to improve the quality of therapy for gender, sexuality and relationship diverse clients.

The decision as to whether to re-sign for an revised MoU inclusive of Trans and Asexuality has been referred to the Board of Governors who meet in March.It’s been indicated to me that it’s likely they will feel signing up will not be consistent with BACP’s policy and practice.I seriously doubt the Governors of BACP will be a particularly well informed group of individuals who will have their finger on the pulse regarding trans and asexuality issues so this a great way for the Executive of BACP to pass the buck. I’d be curious to see any briefing papers they have prepared for the Board on the issues involved in whether to sign back up to MoU v2.

I was proud to be made a Fellow of BACP back in 2007 for my “distinguished service to the field” but that award has been pretty hollow given how BACP have rarely sought advice and guidance on what they might need to be doing to meet the needs of their membership with regard to helping counsellors improve the mental health of our communities.

My BACP membership is due for renewal next month, but I will not be renewing and I will instead be taking up membership of a smaller but much more responsive professional body – the National Counselling Society who have indicated that they have voted for an inclusive MoU v.2 and that my status of a Senior Accredited member can be transferred to their organisation and that their Professional Standards Committee would welcome my application for a Fellowship.They are also keen to have have my expertise contribute to the way the organisation might support their members.

Perhaps other disaffected members of BACP might want to consider whether they want to continue their membership!

Yesterday, I was invited to meet with Norman Lamb the Minister for Care and Support and the heads (or their representatives) of most of the major psy/therapy organisations (BACP, UKCP, BPS, National Counselling Society, British Psychoanalytic Council, Relate, BABCP, Assoc of Christian Counsellors, Chair of GLAAD representing the Royal College of GP’s) PACE and Stonewall. The topic of this ’round table’ was Conversion Therapy which the Minister told us he was very concerned about and wanted to establish what was happening and what the government might do about it.

Professor Michael King was there representing the Royal College of Psychiatrists and both he and I were invited to make presentations – him on the evidence of efficacy and harm and me, on the training needs for therapists and what the professional bodies should be doing. I’d been waiting for an opportunity like this for my entire career!

David Pink from UKCP gave some background to the issue as UKCP have been taking the lead on this for a while now and recently produced a booklet commissioned by the Government for the NHS Choices website. Pink Therapy had a hand in this and it seems an important step at the Government making it clear that Conversion Therapy has no place in ethical health care for LGB people.

After Mike King gave some background on the history of conversion therapy and the lack of evidence for its benefit and plenty of evidence for it’s harm, I had around 20 minutes to present my own thoughts.

This is a slightly tidied up version of what I said:

Dept of Health Round Table on Conversion Therapy

Training & Policy

Whilst I’m concerned about religiously motivated Conversion Therapy and have been professionally active on this issue for over two decades, I’m much more concerned with Professor King’s data about 1:6 mainstream therapists of your organisations agreeing to contracts to reduce SSA or cure people. Most of these people are not overtly religiously motivated and so might not feel your Conversion Therapy policy statements apply to them.

These were well meaning mainstream and secular therapists who were poorly trained and inadequately prepared to know how to respond to a highly distressed client. Training in understanding what is different about working with gender or sexual minorities is either absent or patchy in most British therapy training courses and so therapists don’t know how to respond and often have little cultural competency in understanding the social contexts in which their clients live. Noble humanistic concepts about the clients right to self determination are in conflict with what might be a lack of choice over the gender of their sexual partners. The people presenting for ‘gay cure’ are generally likely to be those who have a fixed and enduring sexual identity (Kinsey 6’s) and whereas sexuality can be quite plastic for many people and there are plenty of examples of situational homosexuality amongst heterosexuals in single sex environments and sexual fluidity over a lifespan for many LGB and T people, the people seeking ‘cure’ are unlikely to be those people who feel unable to change.

In some contexts (lesbian and gay Muslim especially) lesbians and gay men may be facing honour killings from family members or alienation from their community and families. They maybe literally pleading for their lives.

I’m also interested to know how those organisations which have Christian Counsellors or Pastoral Counsellors like Assoc Christian Counselling and BACP’s Association for Pastoral and Spiritual Care Counselling will monitor whether conversion therapy is being undertaken organisations? Changing policy and forbidding something doesn’t make it go away.

I’m interested to hear what other colleagues are doing to ensure their Policy Statements are translated into action and how they propose to train their members in ensuring they can respond appropriately to requests for change.

However, it goes wider than this in delivering culturally safe and appropriate mental health services. An example is that whilst we now have full equality in Gay Marriage, we should bear in mind that research shows that between 50-80% gay male couples are are not sexually exclusive. So whilst Relate has become less heteronormative over the years, it is still virtually impossible for a gay couple to get help in opening up their sexual relationship, when the training of the therapists in Relate has been about helping couples maintain sexual fidelity and keeping families together.

Research is showing that Bisexuals get offered conversion therapy from mainstream counselling organisations too! Some therapists feel they should just help the bisexual pick one identity and either be heterosexual or gay. (Ref: Bisexuality Report and Richards and Barker, 2013)

My recommendations

Accrediting a course, should mean the course gets audited for what they are teaching about working with gender and sexual diversity clients. I’m interested in therapists being culturally safe to offer therapy to sex minority communities. So that LGBT people are afforded dignity to live within their own values and norms. Such training in understanding developmental theory, life stages and relationship models etc should be integrated and run throughout whole curriculum and not be an optional add on for a single workshop. The BPS Guidelines for working therapeutically with gender and sexual minority clients are most helpful and I’d like courses seeking accreditation to be asked to embed these guidelines in their training of therapists so that throughout the curricula therapists are learning how to work with diversity.

Post Qualified counsellors faced with requests for change need CPD to help them better handle these issues. A big stick or forbidding conversion therapy is not helpful. You have a duty of care to your members to support them in know how best to effectively respond to genuine distress and requests for ‘cure’.

Therapists and supervisors need training in how to work with the issues. Our own workshops for supervisors were frequently cancelled due to low take up, it seems supervisors (who may well have been trained at a time when homosexuality was still classified as a mental disorder) feel they are above or beyond the need for training in how to supervise therapy with LGBT clients.

Specifically with regard to Requests for ‘Cure’, I recommend a training pack be produced – with video, experiential exercises and some theoretical material and resources which addresses how to work with these issues. We should then offer to train counsellor trainers in how to use the pack so that they can then deliver training to their students. It would be good if the Dept of Health could help us produce this material – making a video with a Muslim actor playing a gay client who is conflict with his cultural and faith beliefs and sexual orientation.

You will see I’ve used the concept of Cultural Safety. This arose in Nurse Education in New Zealand and here’s a short explanation:Cultural safety relates to the experience of the recipient of nursing service and extends beyond cultural awareness and cultural sensitivity. It provides consumers of nursing services with the power to comment on practices and contribute to the achievement of positive health outcomes and experiences. It also enables them to participate in changing any negatively perceived or experienced service. The Council’s definition of cultural safety is:

The effective nursing practice of a person or family from another culture, and is determined by that person or family. Culture includes, but is not restricted to, age or generation; gender; sexual orientation; occupation and socioeconomic status; ethnic origin or migrant experience; religious or spiritual belief; and disability

The nurse delivering the nursing service will have undertaken a process of reflection on his or her own cultural identity and will recognise the impact that his or her personal culture has on his or her professional practice. Unsafe cultural practice comprises any action which diminishes, demeans or disempowers the cultural identity and well being of an individual.

After the meeting, I had warm and encouraging approaches from the National Counselling Society and the British Psychoanalytic Council who want us to advise them on what they can be doing. Also within hours the Chief Exec of Relate emailed me asking me to meet with their Head of Training. Interestingly, the representative from BACP remained silent throughout the meeting and afterwards. I hope I shouldn’t be reading too much into this.

There are plans for a follow up meeting and maybe a Memorandum of Understanding which we will hopefully agree.

This is the first time I’ve seen these professional associations coming together on an issue. They are essentially rivals and many competing for members. It was good to see them in agreement about Conversion Therapy and open to hearing my proposals.